Why the study?
Does combination therapy with verapamil and mexiletine suppress VF attacks in a patient with a short-coupled variant of Torsades de Pointes?
Case Report (n=1)
Does combination therapy with verapamil and mexiletine suppress VF attacks in a patient with a short-coupled variant of Torsades de Pointes?
Combination therapy with verapamil and mexiletine may be effective in suppressing electrical storm and diminishing prominent J waves in patients with a short-coupled variant of Torsades de Pointes.
Answers are grounded in this paper and cite their sources.
May support verapamil-mexiletine after sedation in refractory short-coupled TdP; hypothesis-generating, needs prospective validation.
TAKEUCHI, T., et al. : A Case of a Short‐Coupled Variant of Torsades De Pointes with Electrical Storm. This case report describes a short‐coupled variant of Torsades de Pointes with a characteristic ECG pattern consisting of a prominent J wave in leads V 3 –V 6 , in which an electrical storm was evoked with autonomic receptor stimulation and a blockade test. The patient's frequent VF attacks were triggered by short‐coupled premature ventricular contractions with a right bundle branch block morphology and left‐axis deviation, and were suppressed by deep sedation followed by a combination therapy using verapamil and mexiletine. Interestingly, with the use of those drugs, the prominent J wave diminished. The mechanism underlying this syndrome is discussed. (PACE 2003; 26[Pt. I]:632–636)
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Takeuchi et al. (2003) conducted a case report in Short-coupled variant of Torsades de Pointes with electrical storm (n=1). Deep sedation followed by verapamil and mexiletine was evaluated on Suppression of ventricular fibrillation attacks.
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